Organization Active NPI

Tillmans Corner Chiropractic Clinic Inc

  • Chiropractor
  • Mobile, AL
National Provider Identifier
1003229741
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
TILLMANS CORNER CHIROPRACTIC CLINIC INC
Practice address
5369 Highway 90 W Ste C
Mobile, AL 36619-4223
Phone
(251) 661-0322
NPI assigned
Jun 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kenneth Bishop, D.CNPI 1740352814
Title
Owener
Phone
(251) 661-0322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

5369 Highway 90 W Ste C
Mobile, AL 36619-4223

Mailing address

5369 Highway 90 W Ste C
Mobile, AL 36619-4223
Phone (251) 661-0322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180627003809 AL Part B Supplier - Clinic/Group Practice 2961758339 Receives reassigned benefits from 1 practitioner
Practice locations: Mobile, AL

National Provider Directory

National Provider Directory

Locations

5369 Highway 90 W
Ste C
Mobile, AL 36619
Phone (251) 661-0322

5601 Nevius Rd
#A
Mobile, AL 36619
Phone (251) 661-0322

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1003229741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5369 HIGHWAY 90 W STE C",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366194223",
            "telephone_number": "251-661-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5369 HIGHWAY 90 W STE C",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366194223",
            "telephone_number": "251-661-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TILLMANS CORNER CHIROPRACTIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWENER",
        "authorized_official_telephone_number": "251-661-0322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.